Dementia villages offer secured freedom to aging B.C. patients

As you walk through the village grounds, kids are playing on the small field while being supervised by daycare staff.

At the coffee shop across the path, a group of five women are meeting for their weekly book club.

Behind them a family is enjoying a birthday lunch.

Made up of dozens of houses that each fit 12 private bedrooms, the village has restaurants and shops – including a grocery store – that line the outside perimeter, which act as a subtle “fence” to ensure the residents who live inside the village remain inside where they’re safe.

That’s just a small bit of the idea being proposed for a dementia village in Vancouver, as health authorities in parts of B.C. look to modern alternatives to provide 24/7 care for their aging population.

“If people are looking for innovative ways to care for people with dementia, then this model that brings small household and amenities, normal life and vibrancy is worth checking out,” said Jo-Ann Tait, Providence Health Care program director for seniors care and palliative services.

An estimated 564,000 Canadians were living with dementia in 2016 – a number that the Alzheimer’s Society predicts will nearly double to 940,000 people by 2031.

The idea for the village, which follows the De Hogeweyk model in the Netherlands, is to meld security and safety with freedom and to redefine the way those who suffer from dementia can maintain a level of control in their lives while giving families closure of adequate treatment, Tait explained.

Tait is one of the Vancouver-based health officials currently planning a 300-bed village to replace the former St. Vincent’s Hospital in Vancouver.

The project is in its final business plan stages and follows the same guidelines as Metro Vancouver’s first private village, which is set to break ground soon in Langley.

Unlike the five-acre site at the former Bradshaw Elementary School in Langley, the proposed village in Vancouver will be publicly funded.

But in other parts of B.C., the problem is finding space.

A spokesperson for Northern Health told Black Press Media the idea of a village is not completely off the table, but there are logistical issues surrounding getting enough space for such a site.

Interior Health officials said it’s tailoring the care environment to consider physical or structural and psychosocial needs for its residents with dementia, citing 75 per cent of those in care having moderate or higher cognitive difficulties. A project like the dementia village isn’t in the works currently.

The other barrier, is the cost.

B.C.’s senior’s advocate Isobel Mackenzie said assisted living facilities bridge the gap for people who can no longer live on their own but aren’t in need of around-the-clock medical care.

The problem is that while current funding structures provide subsidies for people seeking long-term care, public money isn’t readily available for assisted living facilities that are largely privately run, she said.

“I would like to see us move to a system where they can choose to move the subsidy where they want to go,” she said.

Maria Howard, chief executive of the Alzheimer’s Society of B.C., said there is a significant need for this type of housing since much of what’s available isn’t designed for the unique needs of people with dementia.

Howard said while most people opt to live at home for as long as they can, there is a shortage of programs and supports for people with dementia in communities.

“It’s not just a health-care issue. This is transportation, this is labour, this is education, this is housing,” she said.

Many people transition into long-term care when living at home becomes impossible, and while those facilities are adapting to the needs of people with dementia, they weren’t initially designed for those whose losses are cognitive, she said.

Model focuses on quality, planner says

It’s anticipated that villages constructed in B.C. will see a wait list.

The village model isn’t centred around saving on up front costs, but quality of care, Tait said, “which at the end of the day saves dollars in the health care system.”

Construction of the village is expected to be cost between $200 to $300 million. There is no word yet on a start date or completion date for the project.

If approved, 300 residents already in care homes throughout Vancouver will move into the village.

Tait expects the village will attract volunteers and nursing students interested in learning about this new types of care model in Canada.

Meanwhile, Providence is starting to plan services that would be integrated into the village, including programs like that inter-generational Montessori school, which runs out of the same building as on of its care homes.

The class, for toddlers aged two to five years old, connects “tiny little kids with energy palpable in this building,” with seniors living at the facility, based on programs offered in the Netherlands’ model.

“It’s the work we’re doing right now and over last 10 years anticipating population growth, for those that need to be served,” Tait said.